---
title: What Cornerstones' Advanced ERP Training Means for OCD Referrals
description: What does advanced ERP training in a residential setting look like, and what does it mean for your OCD referrals? A peer-to-peer overview for clinicians.
---

[Blog](https://cornerstonesofmaine.com/blog)

# [What Cornerstones' Advanced ERP Training Means for OCD Referrals](https://cornerstonesofmaine.com/blog/erp-training-ocd-residential-treatment)

 Written by [Cornerstones of Maine](https://cornerstonesofmaine.com/blog/author/cornerstones-of-maine) | Sep 28, 2026, 6:43:45 PM

For clinicians who work regularly with OCD, the question of where to refer a client who needs a higher level of care is not simple. The evidence base for Exposure and Response Prevention is robust. Finding a residential program that applies it with fidelity, in a live-in environment, with staff who understand how the model works outside a therapy room, is a different matter.

Cornerstones of Maine recently completed a two-day, 12-CE advanced training in ERP specifically designed for residential application, hosted at the organization's Biddeford campus. All clinical directors attended. The training was led by Jeanette Nogales, LCMHC, of The OCD and Anxiety Center for Change, and David Bradley, Ph.D., of Southern New Hampshire OCD and Anxiety Services. Clinical staff from Summit Achievement joined for both days.

### Why Residential ERP Requires a Different Skill Set

 

Outpatient ERP is hard enough to do well. The residential context introduces a set of clinical challenges that most ERP training doesn't address, because most ERP training is designed for weekly sessions in a contained setting.

In a residential environment, the client is present around the clock. Support staff interact with them throughout the day, across every situation where OCD symptoms are likely to surface. Family accommodation patterns don't stay outside the treatment door. The exposures are not hypothetical or scheduled. They happen in the living space, at meals, during unstructured time.

The final afternoon of the Cornerstones training was dedicated specifically to these realities: how to engage non-clinical support staff who are present during exposures, how to build the referral relationships that make step-down care coherent rather than abrupt, how to prepare families before discharge so accommodation patterns don't simply resume, and how to help clients generalize the skills built in treatment to life outside the program.

That last piece is where a lot of residential OCD treatment falls short. Skills built inside a structured program don't transfer automatically. The training addressed this directly.

### What the Two Days Covered

 

Day one built the clinical foundation: the mechanics of ERP, why the model works, and how to implement it across the range of obsessive-compulsive presentations the Cornerstones team sees in the young adult population. Day two moved into more advanced clinical territory.

The morning of the second day covered family accommodation, which for many clinicians treating OCD in young adults is where the work gets complicated. It also addressed the integration of Acceptance and Commitment Therapy alongside ERP, and the clinical differentiation of OCD from presentations that can look similar but require a different approach: OCPD, health anxiety, somatic symptom disorders, and the various ways anxiety can mimic or co-occur with OCD in ways that complicate the diagnostic picture.

For clinicians making a residential referral, that last area is important. A program that can accurately distinguish OCD from overlapping presentations, and adjust the treatment approach accordingly, is a meaningfully different referral option than one that applies ERP broadly.

### Building a Shared Clinical Language Across Programs

 

One aspect of the training worth mentioning to referring clinicians is the cross-program element. Inviting clinical staff from Summit Achievement to participate alongside the Cornerstones team reflects something about how the organization thinks about clinical community. Strong step-down care is easier when the programs involved share a common clinical framework and have existing relationships with each other's clinical teams.

That has practical implications for referral. A clinician placing a client at Cornerstones who will eventually step down to another regional program is placing them into a network where clinical communication is more likely to be coherent.

### For Clinicians Considering a Referral

 

Cornerstones of Maine serves young adults ages 18 to 30 across[residential treatment](https://cornerstonesofmaine.com/young-adults-residential-treatment) and[transitional living programs](https://cornerstonesofmaine.com/young-adults-transitional-living) in Biddeford and Portland, Maine. The program's clinical approach includes ERP alongside CBT, DBT, motivational interviewing,[executive function coaching](https://cornerstonesofmaine.com/executive-function-coaching), and family programming.

Clinicians who want to discuss a specific client, understand the program's clinical approach in more depth, or explore what the referral and communication process looks like are encouraged to reach out directly to Bogie Foden at [bfoden@cornerstonesofmaine.com](mailto:bfoden@cornerstonesofmaine.com) or by calling 207-300-9851.

[View full post](https://cornerstonesofmaine.com/blog/erp-training-ocd-residential-treatment)

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